Proposed Bill Provides for Tricare Coverage of Targeted Therapies

After denials by Tricare to cover a young patient's physical therapy on a horse, and similar denials for other beneficiaries, a proposed bill would require the military health insurer to cover certain forms of physical therapy.

Rep Michael Burgess (R-TX) introduced the Rehabilitative Therapy Parity for Military Beneficiaries Act (HR 1705) on Wednesday. The law calls for Tricare to cover "therapies provided on a horse, balance board, bolster, and bench" if these therapeutic exercises or activities are included in the individual's plan of care. APTA was heavily involved in developing the bill's language, which bolsters the argument that a horse, like a ball or balance board, is simply a tool the physical therapist uses and not an alternative form of therapy.

"Every patient is different, has a different set of needs, and therefore may respond very differently to various types of therapy," Burgess stated. "Ensuring access to needed services is critical for patients to maintain, improve, or regain function."

APTA applauds the efforts of Rep Burgess to ensure all patients have access to therapy services, particularly those who are fighting for our country and whose families bear the greatest weight.

Comments

The idea that hippotherapy or equine therapy is an experimental or unproven or alternative therapy is absurd. It has been in use for over 30 years in many places around the US. There are demonstrated benefits for patients with Cerebral Palsy as well as other developmental disabilities which have been unreachable using other modalities or therapeutic tools. For insurance companies to refuse to pay for this type of therapy while they would pay for a therapist to use a therapeutic ball for similar therapy is unconscionable. The organizations involved in providing this type of therapy are, for the most part, non-profit organizations which depend on donations to acquire and maintain the horses as well as volunteers to maintain the facilities, the horses and to provide assistance to the Physical Therapist who is providing the treatment. There are usually 3 volunteers to each patient during a session. All of this is not charged to the insurance company.

Posted by Karen Disbrow
on 4/26/2013 11:06 PM

A bigger issue is the denial of payment by Tricare for services provided by a PTA. This access issue is much more troubling for providers in areas with a large military population. Also the lack of respect for the skill level of the PTA is very disturbing after all of these years of refuting it with requesting review and updating of the Tricare policy on coverage of PT services.

Posted by Liz Reeser
on 4/28/2013 10:52 PM

Is it all tricare insurances that wont pay for PTA services or is it just Tricare Prime? Does Tricare standard or tricare for life pay for PTA services?